Role of Artificial Intelligence in Colonoscopy Detection of Advanced Neoplasias
Authors: Carolina Mangas-Sanjuan, Luisa de-Castro, Joaquín Cubiella, Pilar Díez-Redondo, Adolfo Suárez, María Pellisé, Nereida Fernández, Sara Zarraquiños, Henar Núñez-Rodríguez, Verónica Álvarez-García, Oswaldo Ortiz, Noelia Sala-Miquel, Pedro Zapater, Rodrigo Jover, Carolina Mangas-Sanjuan, Noelia Sala-Miquel, Juan Martínez-Sempere, José R. Aparicio, Francisco A. Ruíz, Luis Compañy, Belén Martínez-Moreno, Blanca Martínez-Andrés, Lucía Medina-Prado, Eva Soriano, Enrique Santana, Pedro Zapater, Rodrigo Jover, María Pellisé, Oswaldo Ortiz, Anna Serradesanferm, Àngels Pozo, Anna Porta, Rebeca Moreira, María Daca-Álvarez, Jaume Grau, Isabel Torà, Karmele Sáez-de-Gordoa, Francesc Balaguer, Eva Vaquero, Sabela Carballal, Ingrid Ordás, Leticia Moreira, Liseth Rivero, Joaquín Cubiella-Fernández, Astrid Díez, Laura Codesido, David R. Remedios-Espino, Sara Zarraquiños, Jesús M. Herrero-Rivas, Laura Rivas-Moral, Manuel Puga, María J. Iglesias-Varela, Noel Pin-Vieito, Pablo Vega-Villaamil, Santiago Soto-Iglesias, Ramiro Macenlle., Adolfo Suárez, Eva Barreiro-Alonso, Lorena Blanco-García, Miguel Fraile-López, Olegario Castaño-Fernández, Óscar L. González-Bernardo, Verónica Álvarez-García, Víctor Jiménez-Beltrán, Pilar Díez-Redondo, Henar Núñez-Rodríguez, Fátima Sánchez-Martín, Luisa de-Castro, Nereida Fernández, Arantza Germade, Lucía Cid, Sara Alonso, Alfonso Martínez-Turnes, Beatriz Romero-Mosquera, Antonio Rodríguez de-Jesús, Natalia García-Morales, Romina Fernández-Poceiro
Journal: Annals of Internal Medicine (2023)

The role of computer-aided detection in identifying advanced colorectal neoplasia is unknown.To evaluate the contribution of computer-aided detection to colonoscopic detection of advanced colorectal neoplasias as well as adenomas, serrated polyps, and nonpolypoid and right-sided lesions.Multicenter, parallel, randomized controlled trial. (ClinicalTrials.gov: NCT04673136).Spanish colorectal cancer screening program.3213 persons with a positive fecal immunochemical test.Enrollees were randomly assigned to colonoscopy with or without computer-aided detection.Advanced colorectal neoplasia was defined as advanced adenoma and/or advanced serrated polyp.The 2 comparison groups showed no significant difference in advanced colorectal neoplasia detection rate (34.8% with intervention vs. 34.6% for controls; adjusted risk ratio [aRR], 1.01 [95% CI, 0.92 to 1.10]) or the mean number of advanced colorectal neoplasias detected per colonoscopy (0.54 [SD, 0.95] with intervention vs. 0.52 [SD, 0.95] for controls; adjusted rate ratio, 1.04 [99.9% CI, 0.88 to 1.22]). Adenoma detection rate also did not differ (64.2% with intervention vs. 62.0% for controls; aRR, 1.06 [99.9% CI, 0.91 to 1.23]). Computer-aided detection increased the mean number of nonpolypoid lesions (0.56 [SD, 1.25] vs. 0.47 [SD, 1.18] for controls; adjusted rate ratio, 1.19 [99.9% CI, 1.01 to 1.41]), proximal adenomas (0.94 [SD, 1.62] vs. 0.81 [SD, 1.52] for controls; adjusted rate ratio, 1.17 [99.9% CI, 1.03 to 1.33]), and lesions of 5 mm or smaller (polyps in general and adenomas and serrated lesions in particular) detected per colonoscopy.The high adenoma detection rate in the control group may limit the generalizability of the findings to endoscopists with low detection rates.Computer-aided detection did not improve colonoscopic identification of advanced colorectal neoplasias.Medtronic.